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Background  Transcatheter aortic valve implantation (TAVI) is the standard treatment for high-risk patients with aortic stenosis (AS); however, alternative treatments for patients who are ineligible for TAVI are controversial.    Case presentation  56 year-old female who required 6 γ dobutamine support due to congestive heart failure was diagnosed as severe aortic stenosis with bicuspid valve. Echocardiography revealed left ventricular ejection fraction (LVEF) was 15%. The patient was relatively young for TAVI, and TAVI was not licensed for patient presenting with a bicuspid aortic valve in places other than the limited institutions in Japan. On pump beating aortic valve replacement (AVR) was performed with selective antegrade coronary artery blood perfusion. She resumed a completely normal lifestyle by 3 weeks after the operation.    Conclusions  A relatively young patient for TAVI who was diagnosed as aortic stenosis with severely reduced ejection fraction and bicuspid valve is reported. Beating AVR with a continuously selective antegrade-perfusion was achieved safely with good clinical results in a patient with severely reduced left ventricular (LV) function. Beating AVR can be considered as a potential alternative for patients who are ineligible for conventional surgical aortic valve replacement (SAVR) and TAVI.

journal of cardiothoracic surgery

Beating aortic valve replacement surgery as an alternative to transcatheter aortic valve implantation in a patient with severe aortic stenosis and left ventricular dysfunction